LOUISVILLE, Ky. (WDRB) -- In all, they have spent nearly 100 years in prison for murder convictions, with little hope of ever leaving the Kentucky State Reformatory in La Grange.

But in mid-September, Danny Castile and William Gaines Smith became two of the first inmates in Kentucky to be granted medical parole under a state pilot program. The program requires the state to release some infirm inmates to private nursing homes where the federal government, through Medicaid, would pay the medical bills.

Two months later, however, Smith, Castile and eight other inmates granted medical parole are still in prison, because no nursing homes or assisted living facilities have agreed to take them.

The inmates' plight has caught the attention of at least one Kentucky lawmaker, who says the problems may prod legislators to revisit the project.

“I think it requires that we go back to the drawing board," said Rep. John Tilley, D-Hopkinsville, head of the house judiciary committee. “It may need to come back to my committee for further thought. There needs to be a plan B if in fact no one will take them.”

Aaron Smith, warden of the prison in La Grange, home of nine of the 10 inmates granted parole, said nursing homes have been reluctant to accept the paroled inmates, "for various reasons."

Steve McClain, director of communications for the Kentucky Association of Health Care Facilities, said it would be a concern to have to explain to family members of patients why a convicted felon was staying at the facility, and it would be a liability for potential lawsuits.

“We are already caring for a vulnerable and aging population so the safety of the residents who are in our facilities is the top priority,” he said. “There's a liability and a regulatory risk for our providers.”

The ultimate goal of the program is cost savings, getting the state out of basically running an expensive nursing home in a wing of the Kentucky State Reformatory and moving as many of those inmates as possible to private facilities.

There are 64 inmates currently in the KSR reformatory, costing state taxpayers nearly $4.5 million a year. Prison officials said it cost $182 per day to care for these inmates, compared to $50 a day on average for a typical inmate.

“It's obviously much cheaper for us to supervise these individuals on parole than it is to incarcerate them,” Aaron Smith said.

Questions on risks

Still, while Kentucky corrections officials haven't been successful so far in placing any of the inmates, Everett Thomas, the re-entry coordinator for KSR, said there are ongoing talks with a facility to possibly take four of the infirmed inmates, though he declined to specify on which inmates or where the facility was.

Of the ten inmates granted medical parole, eight were convicted of murder. The lightest sentence belongs to Thurman Powell, who is serving five years in prison for a wanton endangerment conviction out of Hopkins County. The program excludes sex offenders and death row inmates.

Aaron Smith said the inmates who are chosen are either physically or mentally debilitated and have to be “substantially dependent upon others for daily living activity,” such as clothing, bathing and feeding themselves.

Also, Smith said the inmates must be deemed a “low risk” and have served at least half of their sentence or be already eligible for parole. Kentucky Corrections Commissioner LaDonna Thompson makes the ultimate ruling on which inmates will be paroled; the parole board must then follow the decision.

If the inmates leave the nursing home, have behavioral issues or commit any other parole violation, they would be sent back to prison.

But Castile, who has been in prison on a murder conviction since 1973, told WDRB that he doesn't blame any nursing home for not wanting to take him in, given the brutality of his crime.

“I have no business being around old people in a nursing home,” he said. When asked if he would rather just stay in the prison nursing facility, Castile responded, “Well, it will protect me and it will protect them.”

But for someone like Smith, Castile said, medical parole would be perfect.

“Willie needs to get out of here,” Castile said. “He don't bother nobody.”

Confined to a wheelchair, Smith, 76, has been in prison 54 years, since 1960, when he was convicted of murdering a store clerk in Lexington.

His co-defendant, who was also convicted of murder and sentenced to death for killing a Lexington store clerk during a robbery, was released on parole in 1981.

In a short interview, Smith, who mostly answered with a quick “yes” or “no” and was sometimes unintelligible, said he wanted to get out of prison, but that he wanted to go home, to Lexington.

Another inmate who received medical parole, Fred Lukins, sent to prison in 1999 for murder out of Fayette County, is mostly confined to a bed and said he is dying of cancer and needs constant care.

“I would just like to get out and have a little freedom,” he said in an interview. “I'd like to sit down and get a good meal.”

All of the inmates said they were cared for well in the prison nursing facility, which is sparkling clean, has dorm-like rooms, an exercise yard and seemingly more freedom than other parts of the facility.

Besides maybe getting a little better care – and food – Lukins believes it would be easier for his family to visit him in a nursing facility.

As for being a danger, Lukins said, “I've only committed one crime,” the 1998 murder of his wife, Chasity “Shea” Welch, in Fayette County.A Fayette Circuit Court jury convicted Lukins and he was sentenced to 33 years in prison.

Fayette County Commonwealth's Attorney Ray Larson said Lukins and the other nine medically paroled inmates need to serve out the time handed down by juries and judges. Seven of the ten were sentenced to life in prison and Larson said that the state needs to respect those decisions.

“I believe in jury verdicts,” he said. “Let them serve their time.… I'm kind of a believer in some sort of stability in the system. As a result, I don't believe in letting people out early.”

A difficult decision

Kentucky's project is not unique as a handful of other states have tried similar programs – often with the same problem in finding placements – given the number of elderly inmates is rising nationwide, expected to triple in the next 15 years, according to a study by the American Civil Liberties Union.

According to data compiled by the ACLU, the number of inmates in Kentucky over the age of 50 rose 137 percent from 1997 to 2006 – compared to a 45 percent increase for all prisoners.

Smith, the warden at KSR, said, however, that overcrowding is not as big an issue for this pilot program right now as cost savings.

Under the 1965 law that created Medicaid, anybody entering a state prison forfeited Medicaid eligibility.

But, according to a report by Stateline, which covers state policy, an exception opened up in 1997 when the U.S. Department of Health and Human Services wrote to state Medicaid directors saying inmates who leave state or local facilities for care in hospitals or nursing homes can get their bills paid by Medicaid. Washington covers at least half the costs of the federal-state health care program for the poor in every state, according to Stateline.

McClain, with the Kentucky Association of Health Care Facilities, said he was unaware of any facilities currently in discussions to place any inmates.

He said that it would be up to each individual provider to make that decision to take in any inmates and while the facility wouldn't have to tell other residents or their families a felon was staying there, they should and likely would.

“You would have to answer those questions for those family members on why you let (an inmate) in,” he said. “It's a difficult decision to make. “

Rep. Tilley said he understands that the program is a “double edge sword,” because it would be a great savings for the state but, even if the inmates are not a threat anymore, “you can understand” the hesitance nursing facilities might have.

“Some of these individuals have committed heinous crimes,” he said.

Regardless of whether these initial 10 inmates are placed, Commissioner LaDonna Thompson said the Department of Corrections will continue to recommend medical parole for inmates that qualify and keep trying to find facilities that will take them.

The inmates who have been granted medical parole so far:

·Alfred Lukins: Began serving 33-year prison sentence in 1999 for a murder conviction out of Fayette County.

·Danny Castile: Began serving a life prison sentence in 1973 for a murder conviction out of Monroe County.

·Webb Adams: Began serving a life sentence in 1976 for murder and drug convictions out of Carroll County

·Clyde White: Began serving a 10-year sentence in 2013 for a manslaughter conviction our of Rockcastle County

·Earlene Stewart: Began serving a life sentence in 1990 for a murder conviction out of Muhlenberg County.

·Willie Gaines Smith: Began serving a life sentence in 1960 for a murder conviction out of Fayette County.

·John Ralph: Began serving a life sentence in 1981 for two murder convictions out of Daviess County.

·Thurman Powell: Began serving a five-year sentence in 2013 for a wanton endangerment conviction out of Hopkins County.

·William Pennington: Began serving a life sentence in 1985 for a murder, burglary, attempted murder and wanton endangerment conviction out of Letcher County.·Patrick O'Hara: Began serving a life sentence in 1979 for a murder conviction out of Lyon County.

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